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FHIR® with an international flair

June 20, 2017

I recently had the pleasure of attending and participating in the HL7®FHIR® Connectathon and HL7 Working Group Meeting in Madrid. Infor is a global company, and our products, like the Cloverleaf Integration Suite, are also global. We are dedicated to improving interoperability not only in the US, but throughout the world. International HL7 meetings have a worldwide focus and are a lot less US-centric. That is why it is particularly important to participate in these meetings to not only champion the needs of our global partners and customers, but to continue to get new and fresh perspectives from representatives across the globe.

As part of this trip, I was also able to meet with and discuss our current product development efforts in support of FHIR and API-based interoperability. Infor Cloverleaf has a significant market share in a number of European countries, so I always relish the opportunity to meet partners in person.

I had a chance to chat with a few people from various countries and get their take on the FHIR standard. Everyone was quite positive about the opportunity it provided. Generally, the European FHIR market “feels” much like the US market in terms of both the hype and technology adoption cycles. There is a lot of interest. Work is going on to further profile the FHIR standard for specific use cases such as the Met Mij or “With Me” project in the Netherlands, which is looking to improve patient access to medical records utilizing the FHIR standard.  However, there are still few large scale projects and the use of the standard is still fairly nascent. Much like the US, it is very much still an innovators market.

Most countries in Europe have their own set of health interoperability standards, guides, and policy development organizations that often develop profiles or implementation guides on top of standards to meet their specific needs. In the US, we are familiar with the Consolidated Clinical Document Architecture (C-CDA) specification. In Europe they have their own implementation guides for CDA. Throughout Europe there is a mix of standards use and implementation guides. FHIR is expected to be added to that mix. The specification development activity our counterparts have seen for HL7 v3 and CDA has already picked up in several countries for FHIR. As mentioned, the Netherlands has the Met Mij project. In the UK, the Professional Record Standards Body (PRSB) has been reviewing FHIR and has even created a proof of concept.

Each country’s approach to new interoperability standards seems a little different. Some are starting with patient access, others are looking for FHIR to enable access to data wherever it may reside, and yet others are looking for it to address some of the challenges they see with V3 and CDA. A number of countries in Europe mandated the use of HL7 v3 and are quite invested in its adoption. V3, however, has proven costly and time consuming to implement.

In the US, we do not have many v3 implementations, but we are quite invested in CDA. It does not make sense to rip out and replace the systems that have been heavily invested in. Instead I see the adoption of FHIR being applied to newer use cases that the new standard makes possible or in places where those other standards have simply failed to provide the benefit at a reasonable cost. In the meantime, we can apply technologies like the Cloverleaf Integration Suite and the upcoming FHIR Bridge to enable legacy systems to connect to a FHIR interoperability ecosystem where it is needed.

 

Corey Spears, Director of Interoperability Standards, Infor Healthcare

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